The Toxicity of Liver Directed Yttrium-90 Microspheres in Primary and Metastatic Liver Tumors

Background: Selective Internal Radiation (SIR) therapy with yttrium-90 microspheres has become an alternative approach to treat hepatic tumors. Methods: A single institution retrospective chart review was performed to assess the safety of SIR microspheres in twenty-one patients with hepatic malignancies. The yttrium-90 radiation dose was dependent upon the percentage of tumor involvement of the liver, with a dose modification (reduction) adjusted for macroaggregated albumin (MAA) shunted to the lung. Results: Twenty-one patients underwent twenty-five treatments with SIR microsphere therapy for primary and metastatic liver tumors. One mortality was secondary to fulminant hepatic failure after developing radiation hepatitis. Morbidities included radiation hepatitis ([1]) and peptic ulcer disease ([6]). Conclusions: The application of SIR microspheres has been utilized for a variety of liver tumors. Although it has been a useful treatment option in selected patients, safety still remains an issue.